運用關懷理論照護一位重鬱症合併精神症狀個案之護理經驗

A Nursing Experience of Applying Watson's Caring Theory on a Patient Suffering from Major Depressive Disorder with Psychosis

顏尚玉(Shang-Yu Yen) ； 張學進(Hsueh-Chin Chang) ； 李秀如(Hsiu-Ju Lee)

《榮總護理》 29卷2期 (2012/06) Pp. 118-123

https://doi.org/10.6142/VGHN.29.2.118

摘要

本文係運用關懷照護理論照護一位重鬱症合併精神症狀個案，於整體性護理評估發現有感覺及知覺紊亂、服藥不遵從、個人因應能力失調及照顧者角色緊張等健康問題；護理過程協助個案及家屬覺察負向思考，瞭解精神症狀，教導症狀處理並鼓勵參與治療性團體以增加病識感，並運用關懷照護理論與個案及案妻建立良好護病關係，鼓勵案妻參與照護計畫，增進家庭成員有效溝通，提昇個案持續治療意願、預防疾病復發等健康行為。結果個案情緒改善，精神症狀減少、服藥遵從行為及疾病因應能力增加，與家人互動良好，出院後可規律返診及服藥。盼分享此個案之照護經驗，做為未來照護類似個案之參考。

關鍵字

重鬱症合併精神症狀 ； Watson's關懷理論

並列摘要

This paper described the use of caring theory on a case involving a patient suffering from major depressive disorder with psychosis. Through holistic nursing assessment, we discovered that the patient and family members lacked stress coping skills, the patient's perception was disorganized, and compliancy to medication was poor. We assisted the patient and caregiver to: realize that negative thinking could affect their emotions; understand psychotic symptoms; learn symptom management skills; join therapeutic group to strengthen insight, all in order to enhance his will in continuing treatment by application of Watson caring theory. During hospitalization, the patient's depressed mood improved gradually, his psychotic symptoms including auditory hallucination decreased, his drug compliance and coping skill improved, and his interaction and communication with his family also became more effective. Base on the post discharge follow-up program, we realized he had good drug compliance and regular outpatient clinic visits. These implied that we could focus on the connection between mood status and psychotic symptoms during clinical nursing care to prevent relapse.

並列關鍵字

major depressive disorder with psychosis ； Watson's caring theory